Healthcare Provider Details

I. General information

NPI: 1952091522
Provider Name (Legal Business Name): A PLUS EYES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 FAIRVIEW AVE NE # 2
GRAND RAPIDS MI
49503-1517
US

IV. Provider business mailing address

502 FAIRVIEW AVE NE # 2
GRAND RAPIDS MI
49503-1517
US

V. Phone/Fax

Practice location:
  • Phone: 616-272-5434
  • Fax:
Mailing address:
  • Phone: 231-679-0646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLEGRA PAIGE BURGHER
Title or Position: SOLE MEMBER
Credential: OD
Phone: 231-679-0646